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| # | Location | File | Last Modified |
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| 1 | MCCF_EDI_TAS_IB_2.0_621.zip | TAS+eIns+US3510+SDD+v1.0+-+EICD++Site+Parameters.docx | Wed Sep 26 22:33:20 2018 UTC |
| 2 | MCCF_EDI_TAS_IB_2.0_621.zip | TAS+eIns+US3510+SDD+v1.0+-+EICD++Site+Parameters.docx | Wed Sep 26 23:17:06 2018 UTC |
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| 1 | MCCF EDI T AS EINSURA NCE US3510 | |
| 2 | System Des ign Docume nt | |
| 3 | IB*2.0*602 | |
| 4 | ||
| 5 | ||
| 6 | ||
| 7 | ||
| 8 | Department of Vetera ns Affairs | |
| 9 | December 2 017 | |
| 10 | Version 1. 0 | |
| 11 | User Story Number: U S3510 | |
| 12 | User Story Name: Ele ctronic In surance Co verage Dis covery: Si te Paramet ers | |
| 13 | Subsection : Site Par ameters, S pecial Pay er, Post I nstall and Testing | |
| 14 | ||
| 15 | Epic Taxon omy | |
| 16 | eBiz Com pliance Port Upd ate Increase No Touch TAS Apps | |
| 17 | Story: | |
| 18 | As a... | |
| 19 | I want to. .. | |
| 20 | So that... | |
| 21 | Consumer o f Electron ic Insuran ce Coverag e Discover y (EICD) f unctionali ty | |
| 22 | The EICD f unction to consult s ite parame ters for t he setting s of varia bles by wh ich the as signed Spe cial Payer , patient selection criteria, and appoin tment date boundarie s—as well as the fre quencies a nd duratio ns of spec ific funct ional comp onents—are defined | |
| 23 | The variab les on whi ch the fun ction reli es for its operating rules wil l be readi ly modifia ble and un iformly co mmunicated to all Vi stA instan ces. | |
| 24 | ||
| 25 | ||
| 26 | Site Param eters: | |
| 27 | Database f ield(s) Af fected by the Design : | |
| 28 | Field Name | |
| 29 | New Value | |
| 30 | 350.9,51.3 1 | |
| 31 | EICD PAYER | |
| 32 | This field holds a p ointer to the EICD p ayer entry (#365.12) . It is th e National payer uti lized when requestin g an Elect ronic Insu rance Cove rage Disco very query for a Vet eran. | |
| 33 | ||
| 34 | Field Name | |
| 35 | New Value | |
| 36 | 350.9,51.3 2 | |
| 37 | EICD INQUI RY FREQUEN CY | |
| 38 | This field holds the frequency in days w ith which a new EICD inquiry s hould be p erformed f or any ind ividual qu alified Ve teran. Ini tially set to every 365 days. | |
| 39 | ||
| 40 | Field Name | |
| 41 | New Value | |
| 42 | 350.9,51.3 3 | |
| 43 | EICD APPT START | |
| 44 | This field represent s the star ting date (in days f rom curren t system d ate) for t he appoint ments to b e consider ed when cr eating the EICD extr act. Initi ally set t o 21. | |
| 45 | ||
| 46 | Field Name | |
| 47 | New Value | |
| 48 | 350.9,51.3 4 | |
| 49 | EICD APPT SPAN | |
| 50 | This field represent s the numb er of days ’ appointm ents, afte r the star ting date, to consid er when cr eating the EICD ext ract. Ini tially set to 9. | |
| 51 | ||
| 52 | To clarify use of th e EICD APP T START an d EICD APP T SPAN fie lds, when the extrac t runs on Jan 1st, a ppointment s from Jan 22-30 (in clusive) w ill be con sidered. The Jan 2n d extract will consi der appoin tments fro m Jan 23-3 1 (inclusi ve). The J an 2nd ext ract is pi cking up n ew appoint ments crea ted and on e more day . The EIC D APPT STA RT and EIC D APPT SPA N settings control t his span. | |
| 53 | ||
| 54 | ** NOTE: T here was t alk about an ICR agr eement to create a f ield in th e patient file which detailed the Date/T ime the EI CD extract was compl eted for a specific patient; T BD. | |
| 55 | ||
| 56 | Routine: I BJPI -- “e IV SITE PA RAMETERS S CREEN” | |
| 57 | In subrout ine BLDBE “Build the Batch Ext ract Param eters Sect ion”, add details f or the Ele ctronic In surance Co verage Dis covery ext ract: | |
| 58 | Batch Extr acts | |
| 59 | Extract Selectio n Maximum # to | |
| 60 | Name On/Off Criteria Extract /Day | |
| 61 | Buffer ON n/a 99999 | |
| 62 | Appt ON 10 99999 | |
| 63 | ||
| 64 | EICD ON n/a 99999 | |
| 65 | EICD PAYER : Electron ic Insuran ce Coverag e Discover y - Do Not Link | |
| 66 | EICD INQUI RY FREQUEN CY: 365 | |
| 67 | EICD APPT START: 21 EICD APP T SPAN: 10 | |
| 68 | ||
| 69 | In subrout ine HELP, adjust the help text : | |
| 70 | HELP ; hel p D FULL^V ALM1 W @IO F W !,"Thi s screen d isplays al l of the e IV Site Pa rameters u sed to man age the" W !,"eIV ap plication used for e lectronic Insurance Verificati on." W !!, "The Gener al Paramet ers sectio n concerns overall p arameters for" W !," monitoring the inter face and c ontrolling eIV commu nication b etween" W !,"VistA a nd the EC located in Austin." W !!,"The Batch Extr acts secti on concern s extract- specific p arameters" W !,"incl uding acti ve/inactiv e status a nd selecti on criteri a. Paramet ers” | |
| 71 | W !,”asso ciated wit h a specif ic extract may also be detaile d here.” W !!,"The Service Ty pe Codes s ection con cerns spec ifying up to nine" W !,"Site S elected Se rvice Type Codes whi ch will be sent with " W !,"ins urance inq uiries." D PAUSE^VAL M1 W @IOF S VALMBCK= "R" Q ; | |
| 72 | ||
| 73 | Payer Link ing: | |
| 74 | Option: [ IBCNE PAYE R LINK] “L ink Insura nce Compan ies to Pay ers” | |
| 75 | Routine: I BCNEPM -- “PAYER MA INTENANCE PAYER LIST SCREEN” | |
| 76 | Within the INIT^IBCN EPM tag …. Around li ne 36, add quit … if payer = t he EICD PA YER identi fied in th e site par ameters. You want t o quit bef ore lookin g at “paye r's profes sional ID” . | |
| 77 | ; Next lo op through all payer s. Count u p the numb er of insu rance ; c ompanies t hat have m atching ED I ID numbe rs but no payer link s. ; Thes e are poss ible payer -insurance company l inks that have not y et ; been made. ; S IEN=0 F S IEN=$O(^ IBE(365.12 ,IEN)) Q:' IEN D . I IEN=$$GET 1^DIQ(350. 9,"1,","MB I PAYER"," I") Q ;IB *2*601/DM | |
| 78 | . I IEN=$ $GET1^DIQ( 350.9,"1," ,"EICD PAY ER","I") Q | |
| 79 | ||
| 80 | Option: [I BCN INSURA NCE CO EDI T] “Insura nce Compan y Entry/Ed it” | |
| 81 | Input temp late: [IBE DIT INS CO 1], called by ^ IBCN SC1 | |
| 82 | Add code a fter “PAYE R” if paye r= the EIC D PAYER in site para meters giv e error ms g, delete value from the payer field in file #36 a s they jus t linked i t, then se t Y=”@60” to make it go back t o the @60 tag | |
| 83 | @60 | |
| 84 | S:",7,6,"' [IBY Y="@5 0" | |
| 85 | PAYER | |
| 86 | I X="" S Y ="@50" | |
| 87 | I +$$GET1^ DIQ(350.9, "1,",51.30 ,"I")'=X S Y="@605" | |
| 88 | PAYER////@ | |
| 89 | W !,"LINKI NG TO THE MBI PAYER IS NOT ALL OWED" | |
| 90 | S Y="@60" | |
| 91 | @605 | |
| 92 | I +$$GET1^ DIQ(350.9, "1,",51.31 ,"I")'=X S Y="@50" | |
| 93 | PAYER////@ | |
| 94 | W !,"LINKI NG TO THE ELECTRONIC INSURANCE COVERAGE DISCOVERY PAYER IS N OT ALLOWED " | |
| 95 | S Y="@60" | |
| 96 | @50 | |
| 97 | ||
| 98 | Request HL 7: | |
| 99 | Routine: I BCNEHLM -- “HL7 Regi stration M FN Message ” | |
| 100 | Increase v ersion num ber to all ow FSC to serve a si te properl y | |
| 101 | S IVER ="9" | |
| 102 | ||
| 103 | Post Insta ll: | |
| 104 | Routine: I BY602PO -- Post Inst all | |
| 105 | Send regis tration me ssage to F SC to set HL7 versio n to the p roper numb er | |
| 106 | Loop thoug h all insu rance comp anies and make sure none are l inked to t he EICD pa yer | |
| 107 | POST ; POS T ROUTINE( S) | |
| 108 | N IBXPD,X PDIDTOT | |
| 109 | S XPDIDTO T=2 | |
| 110 | ; | |
| 111 | ; Send si te registr ation mess age to FSC | |
| 112 | D REGMSG( 1) | |
| 113 | ; | |
| 114 | ; Check/r emove any link from an insuran ce to the National E ICD Payer | |
| 115 | D CHKLNK( 2) | |
| 116 | ; | |
| 117 | ; Display s the 'Don e' message and finis hes the pr ogress bar | |
| 118 | D MES^XPD UTL("") | |
| 119 | D MES^XPD UTL("POST- Install Co mpleted.") | |
| 120 | Q | |
| 121 | ; | |
| 122 | REGMSG(IBX PD) ; send site regi stration m essage to FSC | |
| 123 | D BMES^XP DUTL(" STE P "_IBXPD_ " of "_XPD IDTOT) | |
| 124 | D MES^XPD UTL("----- --------") | |
| 125 | D MES^XPD UTL("Sendi ng site re gistration message t o FSC ... ") | |
| 126 | I '$$PROD ^XUPROD(1) D MES^XPD UTL(" N/A - Not a pr oduction a ccount - N o site reg istration message se nt") G REG MSGQ | |
| 127 | D MES^XPD UTL("Sendi ng site re gistration message t o FSC ... ") | |
| 128 | D ^IBCNEH LM | |
| 129 | ; | |
| 130 | REGMSGQ ; | |
| 131 | Q | |
| 132 | ; | |
| 133 | CHKLNK(IBX PD) ; Due to a timin g issue wi th the Nat ional EICD Payer | |
| 134 | ;It's pos sible that a client linked an insurance to the EIC D payer | |
| 135 | ;This is not allowe d. Any suc h link wil l be remov ed | |
| 136 | N IBEICDP Y,IBIEN | |
| 137 | D BMES^XP DUTL(" STE P "_IBXPD_ " of "_XPD IDTOT) | |
| 138 | D MES^XPD UTL("----- --------") | |
| 139 | D MES^XPD UTL("Verif ying Insur ance links to payers ...") | |
| 140 | S IBEICDP Y=0 | |
| 141 | S IBEICDP Y=$O(^IBE( 365.12,"B" ,"Insuranc e Coverage Electroni c Discover y-Do Not L ink",IBEIC DPY)) | |
| 142 | I 'IBEICD PY D BMES^ XPDUTL("In surance Co verage Ele ctronic Di scovery Pa yer has no t been est ablished") G CHKLNKQ | |
| 143 | S IBIEN=0 | |
| 144 | F S IBIE N=$O(^DIC( 36,"AC",IB EICDPY,IBI EN)) Q:'IB IEN D | |
| 145 | . S DIE=" ^DIC(36,", DA=IBIEN,D R="3.1///@ " D ^DIE ; remove th e link | |
| 146 | . W !,"In surance:"_ IBIEN_" "_ $$GET1^DIQ (36,IBIEN_ ",","NAME" ) | |
| 147 | . K DIE,D A,DR | |
| 148 | ; | |
| 149 | CHKLNKQ ; | |
| 150 | Q | |
| 151 | ; | |
| 152 | ||
| 153 | Testing & Utilities: | |
| 154 | Routine: I BCNETST -- “eIV Gate -keeper te st scenari os” | |
| 155 | Add any Ga te-keeper patients n eeded to s upport tes ting of El ectronic I nsurance C overage Di scovery | |
| 156 | Check/Modi fy the App endix in e IV tech ma nual; talk s about te sting eIV | |
| 157 | ||
| 158 |
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